Pancreatic cancer in older adults presents distinct challenges due to underlying comorbidities, functional status, and the lack of universally accepted treatment protocols. It is essential to assess the tolerability and efficacy of treatment in this demographic. The goal of our study was to evaluate the outcomes and tolerability of full-dose chemoradiation in pancreatic cancer patients aged 65 years and older. This retrospective study (2012-2019) involved 24 patients aged 65 years and older diagnosed with pancreatic cancer, all of whom underwent chemoradiotherapy. The cohort was divided into two groups: one receiving adjuvant therapy following surgery, and the other receiving definitive chemoradiotherapy. The primary endpoint was overall survival (OS). The median follow-up period was 13.57 months, with a mean age of 71.46 ± 5.55 years. Of the participants, 9 were treated with definitive chemoradiotherapy, while 15 underwent surgery followed by chemoradiotherapy. The median OS was 13.07 months for the definitive group and 23.4 months for the adjuvant group (P = 0.061). There were no significant associations between OS and factors such as radiotherapy dose, pT stage, pN stage, tumor grade, or the presence of microscopic disease or invasion. All patients completed the radiotherapy regimen, without any severe hematologic toxicity (grade 4-5). In conclusion, this study supports the use of chemoradiotherapy in elderly pancreatic cancer patients, demonstrating its feasibility and tolerability in both adjuvant and definitive treatment contexts.
